44 patients with a stable type B malleolar fracture were randomized to postoperative immobilization using either a removable functional brace or a below-the-knee cast. Patients were assessed for function, pain, comfort, and range of motion over a 52 week follow-up. Results demonstrated no significant differences between groups at any time point on the Olerud-Molander score, VAS pain, or AAOS foot and ankle score. VAS comfort scores significantly favoured the functional brace group at 6 weeks, and range of motion was significantly greater in the functional brace group at 6 weeks.